The document discusses a collaboration between English students and intensive English program (IEP) students at a university to improve health literacy. The English students identified barriers to understanding health information for international students. They then worked with IEP students to simplify existing health documents by adding images, simplifying language, using bullet points, and condensing information. The revised documents had lower grade levels. Through this process, the English students changed their assumptions about IEP students and learned about different healthcare systems and cultures. They were able to form new relationships with the IEP students. The collaboration helped improve health literacy for international students and increase intercultural competence for all.

1. Awareness of health literacy as a public
health/social justice issue
• “Thanks to the courageous mentalities of the IEP
students…I am aware of how significant an issue
health literacy is.”
• “I never took into account that the international
students may not be aware of the health information
and services available to them not only in our cities,
but also even on our campus. This was extremely
worrying to me and opened me up to their level of
health literacy as an injustice.”
Changed assumptions about international students
• “One thing that surprised me about this experience was how open
the IEP students were to learning…they were very curious.”
• “I vow to use the new perspectives I have gained to be more helpful
to international students around me and understand that the barriers
between us can easily be resolved by a simple conversation or
gesture to help.”
• “This project largely changed my assumptions of these
international students…. This process never made me feel as if
these individuals were inferior to myself; instead, it taught me that
they need assistance in finding resources to learn about
information in which they may be lacking.”
Intercultural competence
• “It was fascinating to hear about their culture and identify the
similarities and differences in health care.”
• “I was surprised by how different our healthcare systems were, and the
challenges that arose in the differences in the cultural literacy.”
• “Building relationships with them was fun. I was at an event this past
weekend, and someone came up to me and told me he knew me from
class…. This is a relationship I wouldn’t have formed had it not been
for this project.”
Overcoming Health Literacy Barriers: A Domestic-International Student Collaboration
Christen Bouchard
Intensive English Program – University of Dayton (Dayton, OH)
HEALTH LITERACY
ENG/IEP COLLABORATIVE PROJECT
• “The wide range of skills and
competencies that people develop to
seek out, comprehend, evaluate, and
use health information and concepts
to make informed choices, reduce
health risks, and increase quality of
life” 1
• 75 million US adults have basic or
below basic health literacy. 2
• 21% of US population speaks a
language other than English at home. 3
• 60,000 international students study in
Intensive English Programs. 4
ENG 366: Health Literacy
and Social Justice
• Identify literacy barriers in existing
health information.
• Produce rhetorically effective
healthcare materials and information
for a marginalized group.
IEP RV2: Reading and
Vocabulary Level 2
• Increase reading comprehension
and critical thinking.
• Acquire general and basic academic
vocabulary.
HEALTH DOCUMENT REVISION
1. Zarcadoolas, C., Pleasant, A. F., & Greer, D. S. (2006). Advancing health literacy: A framework for understanding and
action. San Francisco, CA, US: Jossey-Bass.
2. Kutner, M., Greenburg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003
National Assessment of Adult Literacy. NCES 2006-483. National Center for Education Statistics.
3. Ryan, C. (2013). Language use in the United States: 2011. American community survey reports, 2.
4. Institute of International Education. (2016). Open doors data. Retrieved from http://www.iie.org/research-and-publications/
open-doors/data
Special thanks to Collaborator Dr. Ann Biswas, Director of Writing Programs, University of Dayton
OUTCOMES
REFERENCES
Health
Literacy
Funda-
mental
Literacy
Scientific
Literacy
Civic
Literacy
Cultural
Literacy
2) Produce Effective Materials
• Add images.
• Simplify language.
• Use bulleted lists.
• Summarize, condense, reorganize.
1) Identify Literacy Barriers
• MS Word Readability Analysis
• Reading Ease score, Grade Level
• Health Literacy Load Analysis
• Four domains of health literacy
Original Documents Revised Documents
What is
Influenza
(the Flu?)
HOW DO I PROTECT OTHERS AND
MYSELF FROM GETTING INFLUENZA?
I THINK I HAVE INFLUENZA!
WHAT DO I DO NOW?
• Call a doctor
• Stay home so others do not
get sick
• Rest/ stay in bed
• Drink a lot of water
• Eat healthy meals
(vegetables, fruits ...etc.)
DO I HAVE INFLUENZA?
Common symptoms of the flu:
• Body temperature over 98.6°F/ 37°C
and/or chills
• Coughing
• Sore throat
• Runny/stuffy nose
• Muscle/body aches
• Pain in the head
• Unusually tired
• Vomiting/diarrhea
_______________________________
• Get the flu vaccination every
October (after age 6 months)
• Use tissues to blow your nose and
throw them away after use
• Try not to touch your face (eyes,
nose, and mouth)
• Cough into your sleeve instead of
your hand
• Wash your hands a lot with soap
and water
IEP
Students
ENG
Students
ENG Student
Former IEP
Health
Documents Nationalities
2537
7
1
10
Assess IEP Interests
Find Original Text
Revise for IEP
Test with IEP
Revise and Share
10th
grade
5th
grade
Step 1:
Know what type
of doctor you
want to see.
Step 2:
Look for doctors
of that type
around where
you live.
Step 3:
See which of
those doctors
only take
patients that
have health
insurance.
Places Where Doctors Will Accept Patients Who
Do Not Have Health Insurance
Urgent Care Facilities: Urgent Care Clinics are
places with doctors that can treat you for many
different things. They can give you a regular check-
up, or can treat you if you have an emergency.
Walk In Clinics: Walk in Clinics are great for people
who do not have insurance. Walk In Clinics can be
found in s drug store or grocery stores. The Walk in
Clinic can treat you for a sore throat or give you a
flu vaccine.
Reach Out Montgomery County: Reach Out
Montgomery is a free Walk in Clinic near UD for
people who do not have insurance. It has doctors
and nurses that can treat you for many different
illnesses and give you medication to help you if you
are sick.
Step 4:
Go to the website for your health
insurance to find if your health insurance
will pay for a visit to that doctor.
Step 5:
Call the doctor’s office to make sure that
he or she will accept your health
insurance. The insurance will pay for
your visit.
Step 6:
Find out if the doctor will see patients
who walk in or only patients that make an
appointment before they come to the
doctor.
Step 7:
Make an appointment by calling the
doctor’s office. Visit the doctor on the
day of the appointment.
How to Find a Family Doctor
By: Marissa Jama, Charles Yancey, and Katherine Gross
What is a family doctor?
A family doctor is a general doctor. When someone goes to school to become a family doctor they learn
how to help many problems. You can go to a family doctor for your whole life. Family doctors know a
lot about their patients because you can go to the same doctor for many years. In America people go to
see a family doctor once every year. People who are healthy go to see family doctors because they want
to stay healthy.
Here are some steps on how to find a family doctor when you do have health insurance
and when you do not have health insurance:
You Do
Not Have
Health
Insurance